Bullock L, Etchason E, Fitzgerald J F, McGuire W A
Department of Pediatric Gastroenterology, Indiana University School of Medicine, James Whitcomb Riley Hospital for Children, Indianapolis 46223.
JPEN J Parenter Enteral Nutr. 1990 Jan-Feb;14(1):98-100. doi: 10.1177/014860719001400198.
We report a 34-month-old girl with stage IV neuroblastoma who developed hives when parenteral nutrition (PN) containing amino acids, dextrose, electrolytes, minerals, vitamins, and trace elements was infused. Administration of diphenhydramine resulted in disappearance of the rash. Infusion of the PN solution without intravenous fat emulsion produced a similar rash with itching. The pediatric multiple vitamin (PMV) preparation was removed from the PN formula and the formula was infused without incident. The patient was maintained on PN and an oral vitamin supplement with no further complaints. Inadvertent administration of a PN solution containing PMV resulted in a recurrence of hives. Absence of any adverse reactions when the PMV preparation was removed from the PN solution and an allergic reaction when the multivitamin was added to the PN solution support the possibility that the allergic reaction was related to the infusion of the multiple vitamin preparation.
